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10-0731 (RC)1y=,• �� P.O. BOX 1504 4VOICE (760) 777-7012 78-495 CALLE TAMPICO FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 8/25/10 Application Number: 10-00000731 Owner: Property Address: 79785 HIGHWAY 111 STE 101 KOMAR INV APN: 600-020-034- - 23 CORPORATE PLZ STE 24710 . - Application description: REMODEL - COMMERCIAL NEWPORT BEACH,'CA 92660 Property Zoning: COMMERCIAL PARK 3Application valuation: 5000 20,� j Contractor: LrTY OF iA QUiNTA Applicant: Architect or Engineer: K M S CONSTRUCTION SERV L RIVA.Z+CE s)E-T 23 CORPORATE PLAZA, #247' NEWPORT BEACH, CA 92660 (949)718-4844 jCOM 1�1� Lio. No.: 932143 ---n _ ------------------ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: /B-C10License N .: 932143 Date:�/t ^ Contractor: Py'� I' --77Z;;- .77/!!// OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1 _ I I am exempt under Sec. , B.&P.C. for this reason Date: Owner: CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: _ Lender's Address: LQPERMIT -----------------------------------------------— WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 1 have and -will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier ZURICH INS Policy Number 486597004 I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 1� ) 37%00 of the Labor Cade, I shall forthwith comply �with �—those provisions. carate: �./i�lrlPPlicant: Od-1 16 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT ' IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1 . Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property fo insppeyection purposes. ltDate:,� Signature (Applicant or Agent): Application Number . . . . . 10-00000731 ------ Structure Information ADD UNISEX TOILET FACILITY SHELL IMPROV ----- Other struct info . . . . . CODE EDITION 2007/2008 FIRE SPRINKLERS FULLY MIXED-USE OCCUPANCY M/B OCCUPANT LOAD .00 ---------------------------------------------------------------------------- 1ST FLOOR SQUARE FOOTAGE 2824.00 Permit . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 72.00 Plan Check Fee 46.80 Issue Date . . . . Valuation . . . . 5000 Expiration Date 2/15/11 Qty Unit Charge Per Extension BASE FEE 45.00 3.00 9.0000 ---------------------------------------------------------------------------- THOU BLDG 2,001-25,000 27.00 Permit . . . ELECT - ADD/ALT/REM Additional desc . . Permit Fee . . . . 17.25 Plan Check Fee 4.31 Issue Date . . . . Valuation 0 Expiration Date 2/15/11 Qty Unit Charge Per Extension BASE FEE 15.00 3.00 .7500 ------------------------------------------------------------'---------------- PER ELEC DEVICE/FIXTURE 1ST 20 2.25 Permit . . . MECHANICAL Additional desc . Permit Fee . . . . 19.50 Plan Check Fee 4.88 Issue Date . . . . Valuation . . 0 Expiration Date 2/15/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 ---------------------------------------------------------------------------- EA MECH VENT INST/ DUCT ALT 4.50 Permit PLUMBING Additional desc Permit Fee . . 30.00 Issue Date Expiration Date 2/15/11 Qty Unit Charge Per LQPERMIT Plan Check Fee 7.50 Valuation . . . . 0 Extension Application Number .. . . . . 10-00000731 Permit . . . . PLUMBING Qty Unit Charge Per Extension BASE FEE 15.00 2:00 6.0000 EA PLB FIXTURE 12.00 1.00 3.0000 EA PLB WATER INST/ALT./REP 3.00 ---------------------------------------------------------------------------- Special Notes and Comments SHELL IMPROVEMENT - ADD ADDITIONAL UNISEX TOILET FACILITY TO EXISTING TENANT SPACE.101. 2007/2008 CALIFORNIA BUILDING CODES. August 19, 2010 5:19:00 PM AORTEGA ----------------------------------------------------------------------------- Other Fees -. . . . . . . ACCESSIBILITY PLAN REVIEW 4.68 BLDG STDS ADMIN (8B1473) 1.00 ENERGY REVIEW FEE 4.68 Fee summary Charged Paid Credited --------------------------------------------------------- Due Permit Fee Total 138.75 .00 .00 138.75 Plan Check Total 63.49 .00 .00 63.49 Other Fee Total 10.36 .00 .00 10.36 Grand Total 212.60 .00 .00 212.60 0 LQPERMTT II II I' �soJACENT 1 PROPERTY 11 NOT A PART (I II I o JI I. I I . 79=765 G 79.14.4 Hwy 1 79415 Hwy 111 A ��� :::: I 1 1 ' �� Lt I I',i,I COSTCO � WFIOLESl1 LE ' ] ON, ADJACENT PROPERTY NOT A PART ADDRESSING SUM Building "A" - 79-815 Building "B" - 79.825 (includes Suites 10 Building "C" - 79435; (Includes Suttee 10 Building "D" .70-M 1 (Includes Sultes 10 Building "E" - 79-7851 (Includes Suites 10 Building "F"'- 79.7751 (Includes Suites 10 sout+ll Building "G" - 79-765 Building "H" -79.71M f (Includes Suites 10 Building'J" - 79-7051 John R. Hawkins Fire Chief Proudly serving the unincorporated areas of Riverside County and the. Cities of: Banning e.- Beaumont .Beaumont Calimesa Canyon Lake 4. Coachella 4. Desert Hot Springs 11 o• Indian Wells Indio Lake Elsinore La Quinta Moreno Valley Palm Desert Perris 4. Rancho Mirage Rubidoux CSD San Jacinto Temecula Board of Supervisors Bob Buster, District I John Tavaglione, District 2 Jeff Stone, District 3 John Benoit, District 4 Marion Ashley, District 5 RIVERSIDE COUNTY FIRE DEPARTMENT In cooperation with the California Department of Forestry and Fire Protection 77-933 Las Montanas Rd STE 201, • Palm Desert, CA 92211 • (760) 863-8886 • Fax (760) 863-7072 August 12, 2010 RE: TENANT IMPROVEMENT PLAN CHECK LAQ-IO-TI-025 Komar Desert Ctr. 79-785 Hwy 111 #102 La Quinta, CA You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN OCCUPANCY PERMIT. THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION: A minimum 2AIOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible location within 75' walking distance from any point in your building or suite. Fire extinguishers can be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire extinguisher company must service extinguisher yearly. , All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all times. As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire sprinkler system plans for the tenant improvement area are required to be submitted to the Fire Department for review. Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re- inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886. All questions regarding the meaning of these conditions should be referred to the Fire Department Planning & Engineering Staff at (760) 863-8886. Sincerely, Jason Stubble Fire Safety Specialist APPLICATION # AlbDRE TflzAw i4.8 .!4c. lot y VALUATION SQ. PIT. �lst-:FLOOR. 2:nd. FLOOR COVERED PATIO'. ..GARAGE. TYPE. CONST.:. 'OCCUPANCY. A/C FIRE . -SPRINKLER # OF BEDROOM FLOOD. ,ZONE .- 'OF''.,UNIT--S*:: (J) CODE EDITION ROOF TYPE MECHANICAL # VENT FANS # EXHAUST HOOD A/C -<3 TON A/C >3 TON FAU <100,000 BTU FAU. >100,000 BTU DUCT ALTERATION UNIT COUNTS /..;GAS CDD APPROVAL ENGINEER APP. Bi City of La Quinta Building 8z Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # I� 3 Project Address: '7'95 I` 1 0 Owner's Name: Ko r4Aa- DE-9g(zr S . LL A. P. Number: — Q� _ r3 Address: 23 0a2P,) (24-7E peAZoa So / 9`�, 2 Legal Description: Contractor: kp►AILIIL City, ST, Zip: pjjVP0AP- DC -Al, telephone:6? 9- Address: 'Z3, d9a-,Pp R -A Z A Project Description: City, ST, Zip: 1.V1 % 91-1 4 MOUrG�l tC, U Telephone q �`�' 7t�2E- S9490M TO golT�1- I (JB.-, State Lic. # 1/13 City Lic. #; Arch., Engr., Designer. Address: City., ST, Zip: Telephone: •• ; : Construction Type: M Occupancy: Project type (circle one): New Add, n I/(,l . Repair Demo State Lic. #: Name of Contact Person: ��, Sq. Ft.: S # Stories: # Units: Telephone # of Contact Person: 019 - - 7-53 -0 qO Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRA PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit �— Truss Calcs.' Called Contact Person Plan Check Balance Tide 24 Coles. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2id Review, ready for corrections/Issue Electrical n-257 1� Subcontactor List Called Contact Person Plumbing 3� ?• Grant Deed Plans picked up S.M.I. ^ H.O.A. Approval Plans resubmitted Grading IN HOUSE: '"' Review, ready for correction&4wue Developer Impact Fee Planning Approval Called Contact Person A.I.P. �- Pub. Wks. Appr Date of permit issues School Fees I,* ('Vo . To P' Total Permit Fees 1SsUr-' &,'I A c -V . V'VM sts4"? .